Associations Between Dimensional Persistence of ADHD and Adult Sleep Quality in a Prospective Study of Girls

Objectives: We investigated the prospective association between (a) ADHD symptom dimensions, including their persistence and (b) adult sleep quality in a female sample, covarying adult depressive symptoms. Methods: Participants comprised four persistence groups (persisters, partials, desisters, and comparison) based on overall ADHD diagnosis and separate dimensions of inattention and hyperactivity/impulsivity (HI) in childhood, late adolescence, and early adulthood, featuring girls with (n = 140) and without (n = 88) carefully diagnosed ADHD. Results: Only persistence of inattention predicted lower adult sleep quality when covarying young-adult depression, which was also a significant predictor. When additionally covarying stimulant medication use in adulthood, inattention persistence lost significance, although depression maintained significance, with medication use predicting worse sleep quality. Conclusions: Persistence of inattentive (but not HI) symptoms was significantly related to adult sleep quality in the context of concurrent depression. Sleep quality is an important outcome for research on and treatment for ADHD.

Automated summary

This study investigated the prospective association between persistence of ADHD symptom dimensions and adult sleep quality in a female sample, while controlling for adult depressive symptoms. The results showed that only persistence of inattention predicted lower sleep quality in adulthood, even after accounting for young-adult depression. However, when covarying stimulant medication use in adulthood, the significance of inattention persistence decreased, while the significance of depression remained, and medication use predicted worse sleep quality. In conclusion, the persistence of inattentive symptoms is significantly related to adult sleep quality in the context of concurrent depression. Sleep quality is an important outcome for ADHD research and treatment.